Synthesis Of Research On Patient-Centered Medical Homes Brings Systematic Differences Into Relief

Affiliations

¹ Anna D. Sinaiko is a research scientist in the Department of Health Policy and Management at the Harvard T. H. Chan School of Public Health, in Boston, Massachusetts.
² Mary Beth Landrum is a professor of biostatistics in the Department of Health Care Policy at Harvard Medical School, in Boston.
³ David J. Meyers is a doctoral student in the Department of Health Services, Policy, and Practice at the Brown University School of Public Health, in Providence, Rhode Island.
⁴ Shehnaz Alidina is a research associate in the Department of Health Policy and Management, Harvard T. H. Chan School of Public Health.
⁵ Daniel D. Maeng is a research investigator at the Center for Health Research in the Geisinger Health System, in Danville, Pennsylvania.
⁶ Mark W. Friedberg is a senior natural scientist and director at the RAND Corporation in Boston.
⁷ Lisa M. Kern is an associate professor of health care policy and research at Weill Cornell Medical College, in New York City.
⁸ Alison M. Edwards is a senior research biostatistician at Weill Cornell Medical College.
⁹ Signe Peterson Flieger is an assistant professor of public health and community medicine at the Tufts University School of Medicine, in Boston.
¹⁰ Patricia R. Houck is a statistician at UPMC Health Plan, in Pittsburgh, Pennsylvania.
¹¹ Pamela Peele is vice president of health economics at UPMC Health Plan.
¹² Robert J. Reid is an affiliate investigator, Group Health Research Institute, in Seattle, Washington.
¹³ Katharine McGraves-Lloyd is a senior business information analyst at Anthem Inc., in Washington, D.C.
¹⁴ Karl Finison is director of analytic development at Onpoint Health Data, in Portland, Maine.
¹⁵ Meredith B. Rosenthal (mrosenth@hsph.harvard.edu) is a professor of health economics and policy in the Department of Health Policy and Management, Harvard T. H. Chan School of Public Health.

PMID: 28264952
PMCID: PMC5555150
DOI: 10.1377/hlthaff.2016.1235

Synthesis Of Research On Patient-Centered Medical Homes Brings Systematic Differences Into Relief

Anna D Sinaiko et al. Health Aff (Millwood). 2017.

. 2017 Mar 1;36(3):500-508.

doi: 10.1377/hlthaff.2016.1235.

Authors

Affiliations

¹ Anna D. Sinaiko is a research scientist in the Department of Health Policy and Management at the Harvard T. H. Chan School of Public Health, in Boston, Massachusetts.
² Mary Beth Landrum is a professor of biostatistics in the Department of Health Care Policy at Harvard Medical School, in Boston.
³ David J. Meyers is a doctoral student in the Department of Health Services, Policy, and Practice at the Brown University School of Public Health, in Providence, Rhode Island.
⁴ Shehnaz Alidina is a research associate in the Department of Health Policy and Management, Harvard T. H. Chan School of Public Health.
⁵ Daniel D. Maeng is a research investigator at the Center for Health Research in the Geisinger Health System, in Danville, Pennsylvania.
⁶ Mark W. Friedberg is a senior natural scientist and director at the RAND Corporation in Boston.
⁷ Lisa M. Kern is an associate professor of health care policy and research at Weill Cornell Medical College, in New York City.
⁸ Alison M. Edwards is a senior research biostatistician at Weill Cornell Medical College.
⁹ Signe Peterson Flieger is an assistant professor of public health and community medicine at the Tufts University School of Medicine, in Boston.
¹⁰ Patricia R. Houck is a statistician at UPMC Health Plan, in Pittsburgh, Pennsylvania.
¹¹ Pamela Peele is vice president of health economics at UPMC Health Plan.
¹² Robert J. Reid is an affiliate investigator, Group Health Research Institute, in Seattle, Washington.
¹³ Katharine McGraves-Lloyd is a senior business information analyst at Anthem Inc., in Washington, D.C.
¹⁴ Karl Finison is director of analytic development at Onpoint Health Data, in Portland, Maine.
¹⁵ Meredith B. Rosenthal (mrosenth@hsph.harvard.edu) is a professor of health economics and policy in the Department of Health Policy and Management, Harvard T. H. Chan School of Public Health.

PMID: 28264952
PMCID: PMC5555150
DOI: 10.1377/hlthaff.2016.1235

Abstract

The patient-centered medical home (PCMH) model emphasizes comprehensive, coordinated, patient-centered care, with the goals of reducing spending and improving quality. To evaluate the impact of PCMH initiatives on utilization, cost, and quality, we conducted a meta-analysis of methodologically standardized findings from evaluations of eleven major PCMH initiatives. There was significant heterogeneity across individual evaluations in many outcomes. Across evaluations, PCMH initiatives were not associated with changes in the majority of outcomes studied, including primary care, emergency department, and inpatient visits and four quality measures. The initiatives were associated with a 1.5 percent reduction in the use of specialty visits and a 1.2 percent increase in cervical cancer screening among all patients, and a 4.2 percent reduction in total spending (excluding pharmacy spending) and a 1.4 percent increase in breast cancer screening among higher-morbidity patients. These associations were significant. Identification of the components of PCMHs likely to improve outcomes is critical to decisions about investing resources in primary care.

Keywords: Cost of Health Care; Primary Care; Quality Of Care.

Project HOPE—The People-to-People Health Foundation, Inc.

PubMed Disclaimer

Comment in

Evaluating Patient-Centered Medical Homes.
Nelson K, Hebert P, Fihn SD. Nelson K, et al. Health Aff (Millwood). 2017 Jul 1;36(7):1346. doi: 10.1377/hlthaff.2017.0665. Health Aff (Millwood). 2017. PMID: 28679826 No abstract available.
Medical Homes: The Authors Reply.
Sinaiko AD, Rosenthal MB, Meyers DJ. Sinaiko AD, et al. Health Aff (Millwood). 2017 Jul 1;36(7):1347. doi: 10.1377/hlthaff.2017.0666. Health Aff (Millwood). 2017. PMID: 28679827 No abstract available.

References

1. Edwards ST, Bitton A, Hong J, Landon BE. Patient-centered medical home initiatives expanded in 2009–13: providers, patients, and payment incentives increased. Health Aff (Millwood) 2014;33(10):1823–31. - PubMed
1. American Academy of Family Physicians. Joint principles of the patient-centered medical home. Del Med J. 2008;80(1):21–2. - PubMed
1. Alexander JA, Markovitz AR, Paustian ML, Wise CG, El Reda DK, Green LA, et al. Implementation of patient-centered medical homes in adult primary care practices. Med Care Res Rev. 2015;72(4):438–67. - PubMed
1. Hoff T, Weller W, DePuccio M. The patient-centered medical home: a review of recent research. Med Care Res Rev. 2012;69(6):619–44. - PubMed
1. Rosenthal MB, Beckman HB, Forrest DD, Huang ES, Landon BE, Lewis S. Will the patient-centered medical home improve efficiency and reduce costs of care? A measurement and research agenda. Med Care Res Rev. 2010;67(4):476–84. - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- ClinicalTrials.gov

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Synthesis Of Research On Patient-Centered Medical Homes Brings Systematic Differences Into Relief

Affiliations

Synthesis Of Research On Patient-Centered Medical Homes Brings Systematic Differences Into Relief

Authors

Affiliations

Abstract

Comment in

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical